both sides of the strait

(Taiwan English News/Comprehensive report by Zhu Mingzhu)The latest research in the United StatesHigher vitamin D supplementation in adults with “prediabetes” was found to be associated with a lower risk of developing type 2 diabetes. The study was published in the “Annals of Internal Medicine” on the 7th.

In order to assess whether taking vitamin D can reduce the risk of diabetes in patients with “pre-diabetic symptoms”, researchers from Tufts Medical Center in Massachusetts, USA, recruited 4190 adult subjects and randomly assigned them After 3 experimental groups and 1 control group, clinical trials were carried out for 3 years.

According to the study report, a total of 2,097 adults were included in the experimental group (taking vitamin D), of which 475 had “pre-diabetic symptoms”; two groups used inactive vitamin D3, and the other group used active vitamin D. Of the 2,093 people in the control group (taking a placebo), 524 had “prediabetic symptoms.”

The results of the mixed analysis showed that compared with the placebo group, the vitamin D supplementation group reduced the relative risk of diabetes by about 15%, and the absolute risk was reduced by 3.3%, even allowing patients with abnormal blood sugar to return to normal blood sugar.

So the study authors estimated that, when extrapolating their findings to the more than 374 million adults with “prediabetes” worldwide, vitamin D supplementation could delay the onset of diabetes in more than 10 million people.

In this regard, Li Tingwei, director of the Metabolism Department of the Department of Internal Medicine of Wanfang Hospital, Ou Hongyi, director of the Diabetes Prevention Center of Chengda Hospital, and Xie Boxuan, professor of Physiology and Biophysics at the National Defense Medical College, all put forward their analysis. Experts pointed out that the study used high-dose vitamin D, which is not suitable for ordinary people, and high-dose vitamin D may increase the risk of hypercalcemia, hyperuria or kidney stones.

Ou Hongyi said that although the results of the study pointed out that only in groups with low or insufficient blood vitamin D levels, vitamin D supplementation can have the benefit of preventing “pre-diabetes” from progressing to diabetes, but he reminded that in the study, vitamin D supplementation was seen in patients Afterwards, the average blood levels achieved were higher than the generally recognized safe range, and even reached the levels considered “possibly harmful” in the past. In terms of blood sugar balance, it is necessary to consider what the reasonable concentration of vitamin D is.

Xie Boxuan said that the subjects of the study were patients “with pre-diabetic symptoms”, rather than results that the general public can refer to. Therefore, this study does not prove that vitamin D supplementation in the general public can effectively reduce the risk of diabetes.

In addition, the pre-diabetic patients in the study used vitamin D doses up to 1200 international units (IU) and maintained a high blood vitamin D concentration, which seemed to reduce the incidence of diabetes, but long-term use could easily cause hypercalcemia and hyperhemuria, etc. related toxic reactions.

Xie Boxuan added that the recommended daily dietary dose of vitamin D is 400 to 600 international units (IU), and this dose range cannot reach the dose that effectively reduces the incidence of diabetes in the research.

Li Tingwei pointed out that the study analyzed active and inactive vitamin D together. He felt a little doubtful, because inactive vitamin D3 can be used as a nutritional supplement for the general public, but active vitamin D is prescribed by doctors. dangerous, it is recommended to consult a professional physician first.

Finally, Hongyi Ou concluded that although the research provided scientific evidence that vitamin D can prevent “pre-diabetes” from progressing to diabetes, the benefits are limited to strictly screened “pre-diabetes” patients, not the general public. Therefore, he suggested that the general public does not need to rush to supplement vitamin D, and let more research reports in the future verify these results and safety.

※Source: Taiwan Technology Media Center※

American study says vitamin D can prevent diabetes Experts remind: Excessive use may increase the risk of hypercalcemia and hyperuria

[Health Medical Network/Reporter Wang Guanting]A retired man over 60 years old had heart failure in the past, but he did not develop the habit of regular medication and regular heart checks. Until recently, he developed bubble urine and abnormal urination. However, he rushed to the nephrology department for an examination, only to realize that it was because he did not take the heart failure medicine on time, which made the heart function deteriorate again, which in turn led to kidney failure. Afterwards, under the joint treatment of the heart and kidney team, the heart function has improved, and the left ventricular ejection fraction has increased from less than 30% to more than 40% (the normal value is 52-74%), but his kidney function is still poor. Once gone, never to return, he embarked on the fate of kidney dialysis.

To prevent heart failure patients with cardiorenal syndrome, patients should take regular medication and follow up with follow-up visits on a regular basis

Dr. Zhang Minyu from the Department of Nephrology at E-Da Hospital pointed out that heart failure will lead to long-term insufficient blood output, which will gradually affect kidney function. If heart failure patients are not actively treated, chronic renal failure may occur over time, and even progress to uremia, which is serious Patients can only rely on dialysis treatment or kidney transplantation to replace the work of the kidneys to maintain body functions; on the other hand, due to the deterioration of kidney function, they cannot excrete excess water in the body, and the heart is overloaded for a long time, which will aggravate the degree of heart failure. cardiorenal syndrome.

Dr. Zhang Minyu emphasized, “Patients with heart failure should take medication regularly and follow up regularly to avoid the deterioration of both heart and kidney!” “Patients who have entered dialysis should also actively treat heart failure to avoid deterioration into end-stage heart failure.” Appropriate drug treatment will be selected according to the patient’s condition, and the current standard medication for heart failure can be divided into the following four categories:

1. Renin-angiotensin-aldosterone system (RAAS) blockers:Reduce the burden on the heart by dilating blood vessels and lowering blood pressure, including angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB);
2. Beta sympathetic blocker (β-Blocker):It can inhibit the overactivated sympathetic nervous system, slow down the heartbeat, lower blood pressure, and then reduce myocardial oxygen consumption;
3. Mineracorticoid receptor antagonist (MRA):It has the effect of retaining blood potassium and mild diuresis, can reduce cardiac fibrosis, and resist the harm of hormones to cardiovascular, but it cannot be used to treat dialysis patients;
4. Sodium-glucose common transporter-2 inhibitor (SGLT2i):Reduce the reabsorption of sodium ions, promote urine excretion to reduce the burden on the heart, but it cannot be used to treat dialysis patients.

Prevention is essential in life, maintain good habits to reduce the worsening of heart failure

In addition to drug treatment, Dr. Zhang Minyu also reminded patients with heart failure to pay more attention to blood pressure control, maintain good eating habits with less salt, less sugar, and less oil, and quit bad habits such as smoking, drinking, and staying up late for a long time. Risk of worsening failure.

TW2301168365

【Extended reading】

The mortality rate of heart failure is approaching 50%!Patients with high blood pressure are like the first stage of heart failure

A young man who walks with shortness of breath thinks he is overweight and goes to the doctor for heart failure

Source: Health and Medical Network https://www.healthnews.com.tw/readnews.php?id=56658

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A blood test for Alzheimer’s markers could provide a 10-year warning that people can use to slow the progression of Alzheimer’s disease, according to the Thai Red Cross Health Science Center for Emerging Infectious Diseases at Chulalongkorn University’s Faculty of Medicine.

BangkokJanuary 30, 2023 /PRNewswire/ — Chulalongkorn University(Chulalongkorn UniversityPoosanu Thanapornsangsuth (Medical Dr.) explained: “Alzheimer’s disease has an incubation period of 10 to 15 years before symptoms appear. By the time symptoms appear, patients may have lost a large number of brain cells, and it is extremely difficult to restore or salvage the brain. Now, we have a medical technology that can detect the presence of the disease well before retirement age, allowing people to take care of themselves and stay away from dementia.”

Dementia is incurable and can be caused by many causes and many diseases, but the most important culprit is Alzheimer’s disease, followed by vascular disease. The cause of Alzheimer’s disease is still unclear, and there are many influencing factors, including genetics, environment, pollution, stress, etc.

Dementia and Alzheimer’s disease usually occur in people aged 60 and over, with 1 in 16 people aged 60 and over likely to develop Alzheimer’s, and those aged 80 and over Among the elderly, this proportion increases to 1/6.

There are two traditional ways to check for Alzheimer’s before symptoms appear, PET scans (positron emission computed tomography), and spinal taps and subsequent measurement of levels of Alzheimer’s-causing proteins in the spinal fluid.

Currently, the center uses immunotechniques for blood tests instead of spinal fluid, and analysis is done with Simoa (single molecule immunoarray) or LC-MS (mass spectrometry) detectors that detect phosphorylated Tau (which can indicate potential Al the presence of Alzheimer’s disease), and neurofilament chain (a test for brain cell loss). The project was funded by the Institute of Health Systems Research Institute (HSRI).

This method offers a more affordable solution with less procedural complexity and pain, and an accuracy rate of up to 88%.

Subjects were also required to undergo cognitive tests to assess their “brain reserve.”

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